Surgical considerations for treatment of amiodarone-induced thyrotoxicosis.

PURPOSE: We present our experience with surgical management of amiodarone-induced thyrotoxicosis, including preoperative, intraoperative, and postoperative considerations. METHODS: Retrospective review of the medical records and the histological slides and a Medline search of amiodarone and thyroid gland. CONCLUSIONS: Amiodarone is a drug used to treat potentially lethal ventricular arrhythmia. One of the known side effects is thyroid dysfunction. In patients who cannot safely discontinue amiodarone or when medical therapy is ineffective in controlling thyrotoxicosis, thyroidectomy is the treatment of choice.

Effect of cisplatin on the expression of glutathione-S-transferase in the cochlea of the rat.

Glutathione-S-transferase (GST) has been found to conjugate glutathione (GSH) to diverse electrophiles and play a major role in the detoxification of alkylating and platinating agents. However, there is little information regarding the pattern of GST expression in the cochlea. Although cisplatin is ototoxic, its effect on GST in the cochlea is unknown. In the present study we investigated the pattern of GST expression in control and cisplatin-treated cochleas by using the laboratory rat as animal model. Sixteen mature rats were randomly assigned to control or cisplatin groups. After treatment, cochleas were procured and tissues stained by immunohistochemical methods to detect the presence of GST. Optical density measurements were determined to gauge intensity of GST immunostaining. Strong positive GST immunostaining was demonstrated in all cochleas, with the most intense staining found in the spiral ligament and the least in Reissner's membrane. Mean optic density scores were lower for cisplatin-treated cochleas than for control cochleas in all areas analyzed. These findings showed that GST is expressed throughout the rat cochlea, with cisplatin treatment causing its decreased expression.

Hypoparathyroidism counteracts risk factors for osteoporosis.

Although increased bone density has been reported in patients with hypoparathyroidism, it is not known whether hypoparathyroidism can overcome the influence of risk factors for osteoporosis and whether the increased bone density is uniform throughout the entire skeleton or greater in certain regions depending on the bone composition and location. In the current study, bone density was measured in patients with postsurgical hypoparathyroidism and risk factors for osteoporosis. Bone mineral density was determined in eight patients with postsurgical hypoparathyroidism, one with idiopathic hypoparathyroidism, and two with pseudohypoparathyroidism in eight different areas of the skeleton using well established methods: single photon absorptiometry of the radius, dual energy x-ray absorptiometry of the spine, hip, and the whole skeleton, and quantitative computed tomography of the spine. Risk factors for osteoporosis were documented in each subject. The data showed that despite the presence of 1-4 risk factors for osteoporosis, patients with postsurgical hypoparathyroidism had bone mineral density above the normal mean in most locations. The locations with the highest increment were the Ward's triangle and the trochanter area of the proximal femur (dual energy x-ray absorptiometry) (Ward's: Z score + 1.59 +/- 0.57, P < 0.03; trochanter 1.31 +/- 0.42, P < 0.02). The elevation of bone density was not observed in one patient with idiopathic hypoparathyroidism, and variable results were observed in two patients with pseudohypoparathyroidism. Based on these findings, in postsurgical hypoparathyroidism, the bone mineral density is above the normal mean despite the presence of risk factors for osteoporosis, and both cortical and trabecular bone are affected.

The marriage and family therapist: graduate preparation of a mental health professional.

To better acquaint mental health professionals with the educational background of marriage and family therapists, this study examined degree-objective programs offered by 55 academic units in US colleges and universities. Through mailed questionnaires supplemented by telephone follow-ups, information was obtained regarding location of units, enrollment, faculty, admission requirements, program requirements, and therapy models taught. In addition to describing available programs, units with and without accreditation by the American Association of Marriage and Family Therapy's Commission on Accreditation for Marriage and Family Therapy Education were compared.

Birth order and selected work-related personality variables.

PIP: A possible link between birth order and various individual characteristics (e. g., intelligence, potential eminence, need for achievement, sociability) has been suggested by personality theorists such as Adler for over a century. The present study examines whether birth order is associated with selected personality variables that may be related to various work outcomes. 3 of 7 hypotheses were supported and the effect sizes for these were small. Firstborns scored significantly higher than later borns on measures of dominance, good impression, and achievement via conformity. No differences between firstborns and later borns were found in managerial potential, work orientation, achievement via independence, and sociability. The study's sample consisted of 835 public, government, and industrial accountants responding to a national US survey of accounting professionals. The nature of the sample may have been partially responsible for the results obtained. Its homogeneity may have caused any birth order effects to wash out. It can be argued that successful membership in the accountancy profession requires internalization of a set of prescribed rules and standards. It may be that accountants as a group are locked in to a behavioral framework. Any differentiation would result from spurious interpersonal differences, not from predictable birth-order related characteristics. A final interpretation is that birth order effects are nonexistent or statistical artifacts. Given the present data and particularistic sample, however, the authors have insufficient information from which to draw such a conclusion.^ieng

Outcomes of role stress: a multisample constructive replication.

Responses from four separate samples of accountants and hospital employees provided a constructive replication of the Bedeian and Armenakis (1981) model of the causal nexus between role stress and selected outcome variables. We investigated the relationship between both role ambiguity and role conflict--as specific forms of role stress--and job-related tension, job satisfaction, and propensity to leave, using LISREL IV, a technique capable of providing statistical data for a hypothesized population model, as well as for specific causal paths. Results, which support the Bedeian and Armenakis model, are discussed in light of previous research.

Family and child correlates of nutrition knowledge and dietary quality in 10-13 year olds.

Family and child correlates of nutrition knowledge and dietary quality were examined using 97 10-13-year-old children. Results indicated that older, more intelligent, and white subjects had higher scores on a test of nutrition knowledge, and younger, more intelligent subjects whose mothers were employed achieved higher scores on a measure of dietary quality. Tentative explanations are offered.

Measurement of potential for foster parenthood.

The purpose of this study was to construct a scale designed to express, quantify, and summarize evaluations by caseworkers of applicants for foster parenthood. The sample consisted of 472 foster families who were served by 236 caseworkers in 91 agencies in the United States and Canada. The procedure to develop the instrument are described; the distribution of scores, reliability, and validity of the measure are reported; and possible uses of the scale are suggested. The final form includes 54 items organized into nine factors: health, employment and income, time, opportunities for cultural and intellectual development, opportunities for religious and spiritual development, marriage, ability and motivation for foster parenthood, flexibility, and working with the agency and the child's own parents.

Development of children's behavior problems.

This study examined the development of behavior problems of white boys and girls in kindergarten through eighth grade (N = 2,991). Data included general information and ratings by teachers on the Behavior Problem Checklist, a 55-item scale that measures five dimensions of psychopathology. Results indicated two patterns of development. One trend was for conduct problems, personality problems, inadequacy-immaturity, and psychotic signs to increase from kindergarten to about the third grade, decline from the third to sixth grade, and to level off from the sixth through eighth grade. The other trend was for socialized delinquency to increase to about the third grade and to remain level through the eighth grade. Boys experienced more behavior problems than girls on four of the five Checklist dimensions, and youngsters from the lower social classes were more maladjusted than their counterparts from the higher socioeconomic groups.

Congruence of parents' and teachers' ratings of children's behavior problems.

This study compared parents' and teachers' perceptions of behavior disorders in 1,008 white children enrolled in kindergarten through eighth grade. Data included background information and ratings on the Behavior Problem Checklist. For the most part, parents perceived more problems in their children than did teachers. Parents and teachers tended to agree that boys exhibited more deviant behavior than girls and that youngsters from the higher social classes had fewer disorders than those from the lower classes. Parent and teacher judgments were somewhat alike in that both groups tended to observe a pattern in the development of problems that first increased then decreased or first increased then decreased and leveled off across grades. Trends were more gradual for parents and sharper for teachers, or declines were not seen by parents that were seen by teachers. Bivariate correlations between parents' and teachers' evaluations were significant by low or low to moderate. Mother-teacher and father-teacher coefficients differed on Socialized Delinquency but were similar on the other behavioral dimensions. Although significant interactions of parent-teacher relationships with sex and grade were infrequent, correlations between ratings by the two groups of informants were higher for boys than for girls; and correlations between parent and teacher judgments were lower for early grades than for later grades.

Dimensions of problem behavior in learning disabled and normal children.

This study examined behavior disorders of learning disabled (N = 94) and normal (N = 2,991) children in Grades K--8, using the Behavior Problem Checklist. Learning disabled youngsters had significantly more problems on four of the five Checklist dimensions. Few interactions with age, sex, and social class were significant.

Behavior problems of children in regular classes and those diagnosed as requiring speech therapy.

2,991 white children in regular classes and 106 white children requiring speech therapy were compared on Quay's Behavior Problem Checklist. The former had fewer problems checked in areas such as personality disorders and inadequacy-immaturity than did the latter, as expected, although the amount of variance accounted for was small. The groups did not differ on conduct problems and socialized deliquency. A question was raised about variations in psychotic signs.

Work-related motives and self-esteem in American women.

Acknowledging the need for additional research on work-related motives and self-esteem in American women, this study investigated the hypothesis that women with a favorable self-esteem would score high in n Ach, in Pow, and n Auto, whereas women with a less favorable self-esteem would score high in n Aff, n Agg, and n Def. Eighty-five female college students completed Gough and Heilbrun's Adjective Check List and Form B of the Coopersmith Self-Esteem Inventory. Data were analyzed by means of chi square tests in conjunction with the coefficient of association asymmetric lambda. The results indicated that, as predicted, women with a favorable self-esteem scored high in n Ach (p less than .001) and n Pow (p less than .001), while contrary to expectation, they also scored high in n Aff (p less than .05). All other relationships were found to be nonreliable. These findings were interpreted as stressing the importance of the relationship between self-esteem and work-related motives in women.

Behavior problems of Anglo and Mexican-American children.

The present investigation compared Anglo (N = 1,999) and Mexican-American children (N = 192) on the four factors of the Behavior Problem Checklist (BPCL). Teachers provided general information and BPCL ratings. The Anglo children manifested more problems on three of the factors than did the Mexican-American children. Significant interactions of grade, sex, and social class with ethnic group were revealed for two of the factors.

Relationships of children's grade in school, sex, and social class to teachers' ratings on the behavior problem checklist.

The present study investigated the relationships of children's grade in school, sex, and social class to teachers' ratings on the Behavior Problem Checklist (BPCL). The sample consisted of 1,999 white children from kindergarten through fifth grade who were in regular classes. Three conclusions may be drawn from the study. The first is that grade and the interactions of grade with sex and social class are determinants of scores on the BPCL, but that no particular trends are characteristic of the relationships between these and the dependent variables. The second is that sex and social class are also determinants of scores on the BPCL, with boys and children from the lower social classes having more problems and girls and children from the higher social classes having fewer problems. The third is that the differences between schools and between teachers are responsible for more of the variance on the BPCL than grade, sex, and social class.

Treatment of acromegaly by transsphenoidal hypophysectomy with cryoapplication.

The therapeutic effect of transsphenoidal hypophysectomy with cryoapplication has been studied in twenty-nine patients with active acromegaly. The mean follow-up time was 15 months (354 months). A significant improvement of symptoms and signs occurred in all but three patients. The level of plasma immunoreactive growth hormone (IRGH) was reduced in all but two patients and a normal level of plasma IRGH was achieved in sixteen patients. Skin thickness, the level of serum inorganic phosphorus and the urinary excretion of hydroxyproline and calcium were significantly decreased in the great majority of the patients. The operation was not accompanied by any visual complications, but cerebrospinal rhinorrhoea, subsiding spontaneously, developed in two and postoperative meningitis in one patient. Hypothyroidism and adrenocortical deficiency developed in eight, gonadotrophin deficiency in thirteen, and persistent diabetes insipidus in one patient. It is concluded that transsphenoidal hypophysectomy with cryapplication is a safe and effective method for the treatment of acromegalic patients.

TAT need achievement and need affiliation in minimally brain-injured and normal children an their parents.

The families of 16 minimally brain-injured children were compared in need for achievement and need for affiliation with 16 families of normal children. The families were matched on age, sex, and birth order of the children, and on education of the fathers. Needs were measured by means of TAT type cards for both parents and children. The data indicated that the minimally brain-injured children and their mothers were lower in achievement motivation than the normal children and their mothers (rho less than .05). Results on the fathers were in the same direction, but were not significant. In addition, parents of minimally brain-injured children seemed to have a different pattern of influence on their offspring than parents of normal children. The achievement needs of the mothers in the former group were positively related to their children's behavior (rho less than .05), and the achievement needs of the fathers in the latter group were negatively related to their children's behavior (rho less than .05). Finally, there were no differences or relationships found for affiliation motivation.